Cast Implant bars

[adamb4321]

I've got a case that's just arrived in the lab for a screw retained denture on Bredent Fast&Fixed abutments.

Unfortunately we haven't been involved in the planning stage, the patient has a temporary denture that we are supposed to copy but we don't have an imp of the denture just a silicone matrix of the buccal contour.
lly I would like to set up my own denture for try in but the surgeon is reluctant to do this.

In this digital age I would also prefer to get the bar milled (biomet or Astra etc) in titanium but without a verified denture try in I can't see this being an option. As a side question, what sort of mark up would you add to a milled bar in % terms?

Which leaves me with casting the bar. What alloys would be recommended for this? I know people are using NP alloys but I'd rather not use those and as I'm sure it's going to need laser welding the alloy must be zinc free. Any suggestions?

 

[Jo Chen]

I assume this is for a hybrid denture. Don't even start without trying in a verification index first. You can use semi precious if you are going to cast a substructure.

 

[aqdental]

I've got a case that's just arrived in the lab for a screw retained denture on Bredent Fast&Fixed abutments.

Unfortunately we haven't been involved in the planning stage, the patient has a temporary denture that we are supposed to copy but we don't have an imp of the denture just a silicone matrix of the buccal contour.
lly I would like to set up my own denture for try in but the surgeon is reluctant to do this.

In this digital age I would also prefer to get the bar milled (biomet or Astra etc) in titanium but without a verified denture try in I can't see this being an option. As a side question, what sort of mark up would you add to a milled bar in % terms?

Which leaves me with casting the bar. What alloys would be recommended for this? I know people are using NP alloys but I'd rather not use those and as I'm sure it's going to need laser welding the alloy must be zinc free. Any suggestions?

Hi adamb4321, if yor customer wants you to do a hybrid without a try in ( no matter if cad- cam or cast) remind him that as teeth guide implants, they also guide frame design. Doing a frame first and than try to fit teeth over can be ....... Problematic.
And as Joe said, verify your master, this is a MUST in implant work.

 

[adamb4321]

Thankfully the one thing we do have is a verification jig for the master cast. I had a long conversation with the Dr today, he still can't accept that a try in is essential. It's like he thinks its saving time/money by missing out some of the planning stage, it never seems to work out that way!

 

[aqdental]

Thankfully the one thing we do have is a verification jig for the master cast. I had a long conversation with the Dr today, he still can't accept that a try in is essential. It's like he thinks its saving time/money by missing out some of the planning stage, it never seems to work out that way!

Doesn't he needs patient approval of final set-up before completing this hybrid? If he's planning to do a try-in over your frame, why don't do that BEFORE? If he wants you to go to finish, well...... BUONA FORTUNA(good luck).

 

[lcmlabforum]

I would send the case with written note of the fees to remove teeth, reset, and reprocess at the Doctor's cost should this not work out
before you process. Let him sign the 'Try-in approval' sheet on behalf of the patient so he takes the responsibility instead of
just verbal OK. If he sees the dollar and time it takes to do it over, he might just wise up.
It's all about the communication, right?
LCM

 

[rich green]

I've got a case that's just arrived in the lab for a screw retained denture on Bredent Fast&Fixed abutments.

Unfortunately we haven't been involved in the planning stage, the patient has a temporary denture that we are supposed to copy but we don't have an imp of the denture just a silicone matrix of the buccal contour.
lly I would like to set up my own denture for try in but the surgeon is reluctant to do this.

In this digital age I would also prefer to get the bar milled (biomet or Astra etc) in titanium but without a verified denture try in I can't see this being an option. As a side question, what sort of mark up would you add to a milled bar in % terms?

Which leaves me with casting the bar. What alloys would be recommended for this? I know people are using NP alloys but I'd rather not use those and as I'm sure it's going to need laser welding the alloy must be zinc free. Any suggestions?

wow. huge potential for problems.
A milled bar could be done with facial matrix, BUT, whoever mills it will need scan bodies for the implant system. And a milled screw retained bar would go straight to the implants with out the abutments. That is if I am reading the images I see on the web correctly. So If the doc has already purchased abuts then those would go.... Milled bars are usually around 600 to 700. I have seen mark ups in the 600 to 700 range for a total of 1200 to 1400USD. cast with welds can go, as you know, 600.
As with other messages here I would tred carefully on this. It is going to be more expensive than the doc thinks and if it goes south, it could easily be placed on you. As technicians we often try to help our doc friends out. This is starting to sound like herodontics and the kind of case that never goes away. Good luck.

 

[adamb4321]

Sometimes, getting the Dr to change his mind just isn't possible. Biomet and Astra both offer abutment level bars for the Bredent Fast/Fixed so there wouldn't be any issue getting it milled (apart from the lack of a wax try in) I'm going to cast it, the Dr knows he's taking responsibility for the out come

 

[PCDL]

Get the patient to give you the denture, at a bare minimum. You can superimpose the denture over the master cast, roughly...

You can then duplicate the denture, or at least get some better indices to work with. This should put you in the ball park for your bar fabrication. After that, you can reset the teeth on the bar for a final try-in to finalize esthetics and function.

If the doctor isn't willing to work with you on this, be sure he signs off on the design along the way, so you have some recourse to go back on.

 

[rich green]

Sometimes, getting the Dr to change his mind just isn't possible. Biomet and Astra both offer abutment level bars for the Bredent Fast/Fixed so there wouldn't be any issue getting it milled (apart from the lack of a wax try in) I'm going to cast it, the Dr knows he's taking responsibility for the out come

hope all goes well.

 

[alex moheb]

wow. huge potential for problems.
A milled bar could be done with facial matrix, BUT, whoever mills it will need scan bodies for the implant system. And a milled screw retained bar would go straight to the implants with out the abutments. That is if I am reading the images I see on the web correctly. So If the doc has already purchased abuts then those would go.... Milled bars are usually around 600 to 700. I have seen mark ups in the 600 to 700 range for a total of 1200 to 1400USD. cast with welds can go, as you know, 600.
As with other messages here I would tred carefully on this. It is going to be more expensive than the doc thinks and if it goes south, it could easily be placed on you. As technicians we often try to help our doc friends out. This is starting to sound like herodontics and the kind of case that never goes away. Good luck.

Im in California where do you recommend for me to send out the bar milling too? Im doing my first case and ill need a firm to hold my hand through this process not a big lab that i'm just a number.

 

[cdtwade]

California Dental Arts in Cupertino. Talk to Lonnie.

 

[kcdt]

Thankfully the one thing we do have is a verification jig for the master cast. I had a long conversation with the Dr today, he still can't accept that a try in is essential. It's like he thinks its saving time/money by missing out some of the planning stage, it never seems to work out that way!

If he insists on no trial. Make sure he understands that ALL remakes come out of his pocket.

 

[TheLabGuy]

No way, not this guy!!! No try-in, send it elsewhere...I like sleeping at night